Laboratory Question for the Week of July 11, 2016

Laboratory Compliance Question of the Week

Question:

Does Medicare pay for Zika virus tests?

Answer:

According to the Centers for Medicare & Medicaid Services (CMS), Medicare covers Zika virus testing under Medicare Part B as long as the clinical diagnostic laboratory test is reasonable and necessary for the diagnosis or treatment of a person’s illness or injury. It also advises labs that furnish these tests to contact their Medicare administrative contractors (MACs) for guidance on the appropriate billing codes to use on claims and be aware that MACs may request resources and cost information in order to establish appropriate payment amounts for the tests.

 

For more on this, see https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/SE1615.pdf

Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.